Duration of breast-feeding among Thai primigravida women : effect of breast-feeding education

Abstract

Objectives : The study attempted to evaluate the effects of breast-feeding education program on the duration of exclusive breast feeding of mothers 4-6 months after delivery Methods: The design of this study is the non-ramdomized control group pretest-posttest. The subjects in cluded a total of 226 primigravidas who attended antenatal clinic. The experimental group (115) was given breast feeding education twice, during the third trimester of pregnancy and one to two days after delivery, while the control group (111) received the run of the mill information from the hospital. Data were analyzed using Chi-square t-test and Fisher exact test at the bivariate level and logistic regression for multivariate analysis. Results : Bivariate analysis revealed that mean score of knowledge and attitude posttest in the experimental group was significantly higher than in the control group. The proportion of the respondents who performed the proper techniques of breast-feeding and milk expression were also significantly higher in the experimental than in the control group. The percentage of those who continue exclusive breast-feeding until 4-6 months of delivery and the mean duration of exclusive breast-feeding within the first 5 months of delivery were no significantly different between the two groups. A predictive equation model of the breast-feeding behavior 4-6 months after delivery was formulated. The predictors identified were age, occupation, monthly family income. Social support by close cousin, level of HLOC (Health Locus of Control) and post partum contact. Results revealed that breast-feeding education affected only the cognitive and affective but not the desired duration of exclusive breast-feeding. It suggests that merely breast-feeding education is insufficient to prolong the duration of exclusive breast-feeding Recommendation : Health education needs to deal more with how to develop personal skills. There is need to integrate breast-feeding promotion into any health promotion programs designed for home, work place and community as a whole. Efforts in promoting breast-feeding must emphasize environmental support such as specific regulations and services that will facilitate mothers to extend their duration of exclusive breast –feeding. It is vital that breast-feeding advocacy groups in a hospital and community setting should be established. Additional follow up these two groups beyond the time limit of this study should be undertaken if one is to determine factor that operate at longer terms. It is also recommended that further study should utilize a combination of the quantitative and qualitative approaches for follow up.